When PopCap underwrote studies on the cognitive benefits of playing casual games with East Carolina University (ECU), it never imagined that the research would inspire the exploration of casual game projects for military use. But the principles PopCap helped examine in those studies are the basis for several projects which could lead to the development of new training aids and in-theater medical diagnostic tools for the United States Armed Forces. And it all began with a bit of fan appreciation.

Back in 2006, PopCap Senior Director of Public Relations Garth Chouteau decided to conduct an informal survey on why fans enjoyed PopCap games. “I started to receive the occasional e-mail or call from customers, and being the inquisitive PR person that I am, I would generally take that opportunity to ask them why they liked the games, what they liked about the games,” Chouteau told Ars. “After getting enough of those comments to the effect of ‘These games, they help me relax,’ ‘They seem to make my mind sharper,’ or ‘They provide some type of mental exercise,’ I said to myself, 'We need to understand if this is broadly true. We need a bigger sample.'”

So PopCap hired a company called Information Solutions Group to conduct a formal survey of just over 1,000 customers, asking if they derived any benefits aside from entertainment out of playing PopCap games. "Stress relief was something that three-quarters or more, I think it was 77 percent specifically, chose,” said Chouteau. “And I believe it was 81 percent who cited cognitive exercise.”

PopCap then reached out to departments at multiple universities in the hopes of sponsoring a more rigorous study to understand these effects. Dr. Carmen Russoniello, professor and director of the Psychophysiology and Biofeedback Lab at East Carolina University, gave the most enthusiastic response. “He had a lot of experience in various types of recreational therapy, and he was intrigued by the idea,” said Chouteau.

Having fun is healthy

Russoniello’s research is inspired by his experience asa recreational therapist. His dissertation was conducted at an inpatient alcoholic treatment facility, where he tested the hypothesis that stress-reduction ought to be measurable physiologically. To prove that hypothesis, experimental groups were assigned tasks that required different amounts of oxygen to perform.

“What we found was, not only psychologically did these people report that they felt better, but we could see biochemical changes that were significant between the groups,” he said. For example, the groups that conducted less strenuous activity had lower levels of cortisol, a hormone released in response to stress.

“I was looking for ways to measure these same kinds of activities, which led me to biofeedback, and it turns out that I could use it for intervention as well as to measure the effects of other things on people, which is one of its real benefits,” said Dr. Russoniello. “I can hook you up and see if it works. It really has an advantage of being able to quantify an outcome of a stimulus, like an activity.”

An activity like playing casual video games, for example.

Less stress, better mood

The first PopCap-sponsored study at ECU was titled “A Randomized, Controlled Study of the Effectiveness of PopCap Video Games in Reducing Stress and Improving Mood.” The researchers measured the heart rate variability (HRV) and alpha wave activity among experimental subjects who were given a choice of playing Peggle, Bejeweled, or Bookworm.

“HRV tells you about a thousand times more than your pulse,” said Russoniello. “One of the first things the students notice when someone’s hooked up to HRV is that their heart rate vacillates. Like when a nurse takes [a pulse] and says that it’s 72, it’s actually 72, 68, 80, 69, and that’s important, that variability.” According to Russoniello, heart rate variability can be predictive of depression, anorexia nervosa, and diabetes, among other conditions, and it can also be used to measure stress levels.

As for alpha waves, measuring their strength in both the left and right sides of the brain and measuring the level of synchrony between the hemispheres can measure mood variances such as depression or mania.

Analysis of alpha wave and HRV data from the experiment indicated that the experimental group that played the games exhibited fewer signs of depression or anxiety than a control group. Some of these variances were dependent upon the subject's gender or which game was chosen, suggesting to Russoniello the idea of prescribing specific games to specific patients in order to achieve desired results. The researchers determined that more study was needed.

Casual games as mental health prescription

In addition to another set of lab sessions, the experimental group was instructed to play a casual video game of their choice at home for at least 30 minutes three times per week, with at least 24 hours between each session, for a month. Their post-study scores on the standard nine-item depression scale of the Patient Health Questionnaire demonstrated statistically meaningful reductions in depression symptoms.

Subjects also took a self-administered psychological assessment of mood called the Profile of Mood States, which showed that anger, depression, fatigue, and confusion were all reduced by at least 50 percent in the experimental group. Anxiety levels were also reduced.

The third study being underwritten by PopCap is currently underway and will drill down further into the results of the second study by looking at how casual games might be used in combination with other therapies to combat clinical depression. ECU is also conducting studies into the effects of casual games that are separate from the PopCap-sponsored research. The preliminary results of one of these offshoot studies suggest that playing casual video games can improve a person’s ability to make decisions and respond quickly to a stimulus.

The sum total of the experimental results from all of these studies convinced Russoniello to move forward with proposals to the Department of Defense for military applications of casual game play (though he stressed that these are still just proposals and that there are no projects currently underway with the DOD).

The concept of using casual games for military training purposes is not new. One of Russoniello’s research partners, Dr. Vadim Pougatchev, was involved in just such an initiative in the Soviet Union.

“In the late 80s I was part of the project to develop a special computer program to provide neurocognitive assessment and training for high-risk operators,” Pougatchev told Ars. “This program was implemented in the form of a simple game called Captain Nemo. It appeared that this program was also used to train Soviet Air Force and Navy personnel. Later we found out that besides military pilots, candidates to cosmonauts were trained with it.”

I don't see much value in these studies. Nobody is arguing that stress is healthy, and it's well known relaxing activities will help, so that is pointless to attempt to prove. If you're attempting to make the point that Popcap games are healthier for you than something else, then have that something else as the control and then you have an actually valuable trial.

Have 3 groups instead: one is assigned to only relax/meditate 30 minutes per day, one is assigned to play a casual game 30 minutes per day, one is assigned to jog 30 minutes per day. Follow up on compliance. Then, you'll be able to argue that video games actually are the superior way to relax and reduce stress.

And why does almost every paragraph on page 2 contain "according to Dr. Russoniello" in one form or another?

I'm wondering if casual games can delay the onset of diseases like Alzheimers?

Studies already performed show that activities that require cognitive thought are more effective than medication at helping stave off the effects, and have benefits that continue to slow the advancement even six months after the activities have been halted while medication alone results in a net negative.

Have 3 groups instead: one is assigned to only relax/meditate 30 minutes per day, one is assigned to play a casual game 30 minutes per day, one is assigned to jog 30 minutes per day.

You can keep your jogging (horrible exercise for women, fyi), and for some, casual games are their meditation.

Please don't confuse scientific skepticism and demand for quality controls with personal preference. I don't personally care which method you use to relax. I myself play games for that purpose (not Popcap's though).

I don't see much value in these studies. Nobody is arguing that stress is healthy, and it's well known relaxing activities will help, so that is pointless to attempt to prove. If you're attempting to make the point that Popcap games are healthier for you than something else, then have that something else as the control and then you have an actually valuable trial.

The value is that, anecdotally, the lay person associates gaming with violence, antisocial behaviour, and mental disorders. Most of us have come up against the lonely, introverted, probably depressed stereotype at some stage. The study helps us take one tiny step away from the game distrust and suspicion prevalent in mainstream media.

All I know is that I play one of those games for a half hour and it's worth 10 to 15 points lowering my blood pressure. I've actually measured it. Also its a good way to slowly decompress after a busy day. There might actually be something to the study.

Have 3 groups instead: one is assigned to only relax/meditate 30 minutes per day, one is assigned to play a casual game 30 minutes per day, one is assigned to jog 30 minutes per day.

You can keep your jogging (horrible exercise for women, fyi), and for some, casual games are their meditation.

Please don't confuse scientific skepticism and demand for quality controls with personal preference. I don't personally care which method you use to relax. I myself play games for that purpose (not Popcap's though).

Did you miss the part where they can trojan in both diagnostic, predictive, and therapeutic components into the game?

By all means, increase the scientific rigor, but don't dismiss the thesis without the proof. At this point they are only proposing mechanisms through which to utilize games, which is really only a feedback loop, as a means to decrease stress (which you concede is reasonable), but not only.

Because it can adapt (increase difficulty, decrease sound, play background effects, etc) it has secondary aspects that are being explored.

Decreasing stress was only the initial trigger for this exploratory research. Increasing capability as well as measuring it are two things you cannot get from, as you proposed, jogging since there is no feedback loop, and meditation offers no concrete way to expose your mindset in a manner that allows it to be used as a diagnostic.

Games have scores, rhythms, and reaction times to tell a person what is going on internally.

Decreasing stress was only the initial trigger for this exploratory research. Increasing capability as well as measuring it are two things you cannot get from, as you proposed, jogging since there is no feedback loop, and meditation offers no concrete way to expose your mindset in a manner that allows it to be used as a diagnostic.

Games have scores, rhythms, and reaction times to tell a person what is going on internally.

EEG and HRV were used as measures of response here. As you should expect, exercise affects those. Reducing stress affects those. Meditation affects those. In fact, Russoniello's original article notes that these changes are expected because they indicate relaxation.

Embedding diagnostics in a game is a matter of known neuropsychological/physiological tests working even embedded in a game. That's a solid idea, but I didn't comment on it above.

I was not dismissing that it's possible, I was dismissing the implicit conclusion that everybody is tempted to draw that from these studies you can decide that gaming has special benefits and there may be reason to choose it over other activities. They're just not that good (the studies, not the games). Specifically, any activity you choose will affect these variables. And meditation doesn't require you to sit at a computer, and exercise will give you other health benefits as well including known mood benefits. So if you're ever going to recommend gaming over them you'll need solid evidence (and if not, is it something to write home about?).

Military simulators, surgery simulators, biofeedback (where you measure the biomarker during the activity rather than after), exergaming, motivational gaming etc. are all studied things where games are irreplaceable. They shouldn't be confused with the ostensible benefits of playing Bejeweled at home every day.

Decreasing stress was only the initial trigger for this exploratory research. Increasing capability as well as measuring it are two things you cannot get from, as you proposed, jogging since there is no feedback loop, and meditation offers no concrete way to expose your mindset in a manner that allows it to be used as a diagnostic.

Games have scores, rhythms, and reaction times to tell a person what is going on internally.

The point of the article was that games have obvious external feedback systems that could be easily monitored, assessed, and reviewed.

Quote:

EEG and HRV were used as measures of response here. As you should expect, exercise affects those. Reducing stress affects those. Meditation affects those. In fact, Russoniello's original article notes that these changes are expected because they indicate relaxation.

Correct, but the point of the article is that video games are easier to use than alternative forms of EEG/HRV modification.

Quote:

Embedding diagnostics in a game is a matter of known neuropsychological/physiological tests working even embedded in a game. That's a solid idea, but I didn't comment on it above.

I was not dismissing that it's possible, I was dismissing the implicit conclusion that everybody is tempted to draw that from these studies you can decide that gaming has special benefits and there may be reason to choose it over other activities.

That's a strawman. I didn't draw that conclusion from the article.

Quote:

They're just not that good (the studies, not the games). Specifically, any activity you choose will affect these variables. And meditation doesn't require you to sit at a computer, and exercise will give you other health benefits as well including known mood benefits. So if you're ever going to recommend gaming over them you'll need solid evidence (and if not, is it something to write home about?).

Again, who recommended video games over meditation and exercise? The article mentioned video games as a medium for use in predictive power and diagnostics, not treatments.

Quote:

Military simulators, surgery simulators, biofeedback (where you measure the biomarker during the activity rather than after), exergaming, motivational gaming etc. are all studied things where games are irreplaceable. They shouldn't be confused with the ostensible benefits of playing Bejeweled at home every day.

And yes, I do game myself. A lot.

And again, I don't see that the article tried to say gaming was the preferred healthful activity.

Correct, but the point of the article is that video games are easier to use than alternative forms of EEG/HRV modification.

[...]

That's a strawman. I didn't draw that conclusion from the article.

[...]

And again, I don't see that the article tried to say gaming was the preferred healthful activity.

I) I did not get the first point from the article at all, nor was there any research in that directionII) If you did not draw that conclusion from the article then there is no argument and no disagreement from me. I was only pointing out that these studies are limited. The comment was on the belief that publicizing them implies health benefits to video games over [substitute anything relaxing], which is not a conclusion that can be drawn here - because why make a big deal out of how relaxing activity makes you relaxed? Pre-emptively arguing against a potential conclusion is not a strawman. Maybe overly zealous, but not an error in argumentation.

"Casual games as a mental health prescription" sure sounds like you would do well to instruct people to play games to reduce stress, and this seems to be a view Russoniello takes in his article - the same wording can be found in the abstract. But there's no reason to do so provided. All in all it seems like featuring a trivial result and a full page of speculation on his part.

Any study about a topic funded by a company that profits from it should be ignored. Conflict of interest. All you've done is give them a free 2 page advertorial.

Why not do the rest? Tobacco company funded study finds cigarettes are good for you.. Oil company funded study debunks climate change.. Fast food company study finds no link between its products and obesity.. The list goes on.

I'd be interested to see a HRV monitor integrated into the actual uniform. Collecting data and storing it to a SD-card monitoring the soldier before boot camp, after boot camp, during battle, after battle, before a tour and after a tour and for willing participants after service. The information might help find where best to place an individual and could also be used to help predict PTSD or fatigue. For instance if the variability of the soldier's heart rate out of combat during a tour or after a tour is above a standard deviation it may help to determine that soldiers mental state, susceptibility to mental trauma and makes them unsuitable for forward line duty. Those soldiers could then be used elsewhere or given the medical attention needed to alleviate the mental strain they are suffering before it becomes unmanageable. By gaining a base line for these soldiers it may help predict that a new recruit coming into service will be susceptible to battle fatigue and should be placed in a job more suited towards them. It could also give insight into training techniques that are effective or detrimental in training a soldier to deal with the stresses of combat. And it couldn’t hurt having a HRV monitor when a soldier is injured. Using a raspberry pi as the computer could allow for the history of the soldier to follow them into an aid station. A corpsman could input basic information such as pain killers used, GPS information or store allergy information.

Isn't this why so many people play Call of Duty and similar games out in the theater? Relative to their insanely stressful jobs, that IS a casual game, since there are obvious good guys and bad guys.

I wonder how much effect CoD and similar have on training soldiers, too, though only the more mundane parts of fighting. The sniper/"zone" training is very interesting, and it always helps to have metrics instead of vague descriptions when learning to control something like that.